March 29, 2011

High blood pressure is called “the silent killer.” This is because it has no symptoms. Fortunately, it’s easy to diagnose. All that is involved is taking one’s blood pressure! The majority of our patients visit our office at least bi-annually for a cleaning. For most patients, that’s more frequent than their visit to their medical doctor. We feel that this is an excellent opportunity to read their blood pressure. This is a complimentary service in our practice that we’re happy to offer to you, our patients and friends!

Sharon, our hygienist, takes a blood pressure reading from a very happy patient!

WHAT IS BLOOD PRESSURE AND WHAT DO THE NUMBERS MEAN?

Blood is carried from the heart to all parts of the body in vessels which are known as arteries. Blood pressure is the force exerted by the blood against the walls of the arteries. With each heart beat the blood is pumped through the arteries. This is when the blood pressure is the highest, called systolic pressure, generated when the heart contracts. When the heart is at rest between beats, the blood pressure falls, called diastolic pressure. Blood pressure is denoted by these systolic and diastolic pressures, written one over the other. Optimal blood pressure in an adult is less than 120 mm Hg systolic and 80 mm Hg diastolic. It is written as 120/80.

A blood pressure cuff called a sphygmomanometer is wrapped around your upper arm. An inflatable bladder briefly cuts off the flow of blood. As it’s deflated, the blood returns to flow allowing the systolic and diastolic pressures to be measured.

DOES BLOOD PRESSURE CHANGE DURING THE DAY?

Yes! Blood pressure is the lowest when you sleep and rises when you awaken. It may rise during the day when you are excited, nervous or extra-active. Some patients even experience a rise in blood pressure when they see the dentist enter the treatment room wearing a white coat! This is called “white coat syndrome.” Because blood pressure readings can vary widely, a single reading is not reliable. Readings are best represented by taking them at different times of the day to establish an average.

SO WHAT IS “HIGH” BLOOD PRESSURE?

High blood pressure or hypertension occurs when constricted arterial blood vessels increase the resistance to blood flow causing blood to exert excessive pressure against the walls of the arteries. The heart has to work harder to pump blood through the narrowed arteries. It can lead to long term damage to the heart, blood vessels and other organs. Blood pressures of 120-139 mm Hg and/or 80-89 mm Hg are considered pre-hypertension. Pre-hypertensive patients are at risk of developing hypertension. A blood pressure of 140 and/or 90 mm Hg or above is considered high.

HOW COMMON IS IT?

Very! It is estimated to cause 1 in every 8 deaths worldwide. High blood pressure affects 25 percent of people living in North America and an even higher percentage in Europe. Almost one-third of people with high blood pressure are unaware of their condition, and about one-quarter do not have their blood pressure under control when they are on medications.

REMEMBER, IT’S A “THE SILENT KILLER”

Hypertension is called “the silent killer” because one-third of the people with it do not know that they have it. This is because hypertension has no symptoms! But, it’s easy to diagnose. All that is involved is taking one’s blood pressure!

WHAT ARE THE CAUSES OF HIGH BLOOD PRESSURE?

The cause of high blood pressure may not be clearly identified. Family history and genetic factors may play a role. In a small percent of patients, hypertension develops as a result of another medical problem such as kidney disease. Hypertension can sometimes be a side effect of a medication. Other contributing factors include obesity (or just being overweight), a salty diet, high cholesterol, physical inactivity, age, excessive alcohol usage and tobacco use.

WHY IS IT IMPORTANT TO CONTROL?

Over time, if the force of blood flow is high, the tissue making up the walls of the arteries that contain the blood gets stretched beyond its healthy limit. This creates problems. Each increase of 20 mm Hg in systolic or 10 mm Hg in diastolic blood pressure above normal is associated with two-fold differences in death rates from stroke, ischemic heart disease and other vascular causes. The longer a person has uncontrolled blood pressure, the greater the risk of developing stroke, heart attack, kidney disease or heart failure. A person with high blood pressure is four times more likely to have a stroke. Up to 70% of strokes are related to high blood pressure!

HOW CAN HIGH BLOOD PRESSURE BE CONTROLLED?

It is important to prevent and control hypertension whenever possible especially with a healthier lifestyle and use of anti-hypertension medications.

WHY IS IT DIFFICULT TO REDUCE MY BLOOD PRESSURE?

Some patients have a difficult time reducing their blood pressure even with medications. Hypertensive patients with medical conditions such as diabetes, kidney disease or coronary artery disease often have the most difficult time managing their hypertensive condition, often taking multiple medications to treat their other medical conditions. Patients with resistant or refractory hypertension are not reaching their blood pressure goal, in spite of full doses of an appropriate three-drug regimen that includes a diuretic.

IS THERE SUCH A THING AS LOW BLOOD PRESSURE?

Low blood pressure or hypotension usually occurs due to inadequate circulation in some part of the body giving rise to immediate symptoms, which are related to which part of the body is getting inadequate circulation (the most sensitive of which is the brain). Low blood pressure can occur from medications, heart and endocrine problems, dehydration and after eating in adults. Treatment consists of identifying and correcting the underlying disorder.

WHAT SHOULD I DO IF MY BLOOD PRESSURE READING IS OF A CONCERN?

Inaccuracies and false blood pressure readings can and do occur. Measurements can also be influenced by time of day, lack of sleep, pain, stress and anxiety, excitement, cold temperatures, exercise and physical exertion, illness, caffeine, alcohol, diet, a full bladder, smoking, and many medications such as decongestants, ibuprofen and sex hormones (estrogen and birth control). If you have received a reading that might be interpreted as being high or even low, we suggest that you speak to your physician about its relevance.

So next time that you’re in the office and you’d like to have your blood pressure read, please feel free to ask. We’re here to help you live a healthier life, both dentally AND medically!